HomeKansas City - USA - Part time jobs for StudentsDenial Escalation Nurse, Virtual - Overland Park, KS 66209

Denial Escalation Nurse, Virtual – Overland Park, KS 66209

Kansas City – USA – Part time jobs for students

Description

SHIFT: Work From Home

SCHEDULE: Full-time


Schedule: Monday – Friday Day Shift | Central Time Zone Hours

Are you looking for a work environment where diversity and inclusion thrive? Submit your application with HCA Healthcare today and find out what it truly means to be a part of a team.

We are committed to providing our colleagues with the support they need. We offer an array of medical, dental, and vision packages as well as several add-on perks to make your benefits package truly customizable to you. Some of our unique benefits we offer part-time and full-time employees include:

  • Student Loan Repayment
  • Tuition Reimbursement/Assistance Programs
  • 401k (100% annual match – 3%-9% of pay based on years of service)
  • Identity Theft Protection discounts
  • Auto, Home, and Life Insurance options
  • Adoption Assistance
  • Employee Stock Purchase Program (ESPP)

We value your contributions. Our employee recognition programs encourage our teams to raise the bar. Come be a part of the change!

As a Denial Escalation Nurse, you will be responsible for providing clinical input and interpretation for payer disputes submitted by the Denial Escalation and Legal Resolution Department.

In this role you will

  • Compose clinical dispute letters to send to payers for denial reconsiderations utilizing documentation, contract language, or voice recordings as applicable
  • Present a concise medical summary within each dispute based on support from the medical record
  • Demonstrate understanding of use of all Medical Necessity software, including but not limited to InterQual©
  • Demonstrate ability to interpret medical payer policy requirements Strong ability to research evidence‐based practices
  • Contact appropriate parties (internal and/or external) as needed for additional information to properly formulate the clinical appeal.
  • Determine root cause of each denial and apply company‐specific coding for trending and analysis
  • Update the patient account record to identify actions taken on the account
  • Identify problem accounts/processes/trends and escalate as appropriate

Qualifications

  • Currently Licensed as a Registered Nurse (RN) or (LPN/LVN) in the state(s) of practice and/or has an active compact license, in accordance with law and regulation
  • Associate’s degree required
  • 4-5 years of healthcare experience in an acute care hospital. Utilization Review, appeals, denials, and managed care contracting experience
  • Resource or Pool Nurse experience preferred

Parallon is an industry leader in revenue cycle services. We partner with over 650 hospitals and 2,400 physician practices nation-wide. Our parent company, HCA Healthcare has been consistently named a World’s Most Ethical Company by Ethisphere and is ranked in the Fortune 100. We are dedicated to ensuring our patients have the best experience even after they leave our facilities.

HCA Healthcare is dedicated to the growth and development of our colleagues. We will provide you the tools and resources you need to succeed in our organization. We are actively reviewing applications. Highly qualified candidates will be promptly contacted for interviews. Submit your application and help us raise the bar in patient care!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.



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